Senior Manager, Revenue Cycle Management

Job Description

The Opportunity

The Sr. Manager, Revenue Cycle Management will oversee the planning, organization, and coordination of daily revenue cycle operations to ensure effective processes for Billing, claims processing, revenue collections, and overall payment functions, including cash posting for all Insurances and patients. Execute Revenue Cycle strategies in alignment with the business objectives. Improve days sales outstanding and collection percentage to meet the cashflow target. Ensure compliance with collection policies within the Revenue cycle areas, including full responsibility for acquired entities, overseas team management, and third-party collection agencies.

Responsibilities:

Oversee the planning, organization, direction, and implementation of all claims management processes and controls to ensure the accuracy and timeliness of claim submissions, collections efforts, and payment distribution in compliance with contractual, state, and federal regulations

Stay updated on insurance industry regulations, policies, and coding standards, ensuring compliance and implementing necessary changes

Ensures efficient accounts receivable management. Use routine monitoring reports, such as claim submission rates, denial rates, and reimbursement trends, to oversee the revenue cycle operational functions.

Identify and address areas of improvement to maximize reimbursement and minimize billing errors. Collaborate with insurance companies, B2B clients, and third-party payers to address claims inquiries, appeals, and payment discrepancies.

Monitors work queues responsible for and develops remediation plans for any backlogs that could occur operationally

Supervise patient billing and collections staff on a daily basis, including hiring, monitoring productivity standards, and departmental training

Formulate appropriate professional targets for each of the team members. Ensure collection goals for the department are met.

Attend, participate, and lead at required meetings and work groups.

Foster positive working relationships with internal and external stakeholders, promoting effective communication and collaboration

Provide leadership. Serve as a role model and share resources.

Actively participate in department projects and improvement initiatives

Interface with upper management, including Director, VP, and DVP in Operations, Sales, Marketing, Finance, and R&D.

Provide key financial input on decisions that will drive the strategic/tactical direction of the business unit.

Evaluate existing team performance and propose a target /organizational change to upgrade the talents.

Manage a 30+ collection team, including training, mentoring, goal setting, and performance review.

Any other projects/initiatives assigned in connection with Revenue Cycle management

Required Qualifications:

Bachelor's Degree, preferably in Business /Engineering, Revenue Cycle management; CRCR certified preferred

Minimum 10 years of experience

Experience in handling a team of 50+ billers /$ 500 M+ in accounts receivable

Experience in CMS billing, Account Receivable management is preferred

Experience in multiple EMR/EHR work queue management within RCM

Adaptable, open to change, and able to work in ambiguous situations and respond to new information and unexpected circumstances.

Strong billing requirements knowledge with a detailed understanding of how to strategize accounts receivable and optimize operations

Experience working with third-party collection agencies

Self-motivated and strong leadership to challenge the status quo

Strong Customer Focus and ability to get results.

Demonstrated process improvement skills.

Ability to make business decisions under uncertainty

Demonstrated ability to influence stakeholders, effectively work and communicate in a matrix global organization (Finance, Sales, Marketing, Warehouse, customer service, etc.)

Preferred Qualifications:

CRCR from HFMA or Other Revenue Cycle management related

Full-time